Charlie’s Cesarean Birth

This is a great story of a mom who used Hypnobabies and was comfortable, but ended up needing a cesarean because the baby’s head was tilted a little funny. She has some great tips at the end!

On the evening of May 20th, 2009 (a Wednesday and the day after my 27th birthday), I had finished teaching my last piano lesson for the evening at 7:00 (which I had fortunately rescheduled to a half hour earlier than planned). I had a very strong urge to get some of our last details in order before heading home, so I finished up a few final items on my computer, including compiling a list of people we were planning to email for Charlie’s birth as well as polishing up our requests for his early care. We weren’t technically “due” until May 29th, but we knew that babies are considered full term at 37 weeks and that any time after that is totally normal. While we had most things in line already, there were some things that we hadn’t quite finished. Part of that was because Charlie was our first baby, and we figured we’d be “late” if anything (I was only 38 weeks at this point), but also, we work full time, have a house and three dogs to care for, etc. etc. Either way, we weren’t quite as mentally prepared for what was coming as I would have liked. I definitely had practiced daily with my Hypnobabies scripts and affirmations, but I was certain that Charlie was going to take his time in coming. I also hadn’t gotten my cervix checked at any of my checkups in an effort to keep my head free of the feeling that I was just waiting for the baby to come – I really wanted to let things happen as they were supposed to with as little intervention as possible. Anyway, it turns out that I was very fortunate on a number of fronts that evening – I had rescheduled the lesson, had the feeling that I really needed to get those aforementioned bits of information in line on my laptop, and had the foresight to place a thick blanket and plastic bag in the back of my car…

As I headed home, I placed a few quick calls and then noticed (about 5 minutes into the drive) that my lower back was a little sore – sort of like I had done a bunch of heavy lifting. I remember saying the words, “Charlie, that hurts,” and shifting around in my seat to try to get more comfortable. Just as I was finishing my shifting, I heard a very audible “pop” and started feeling like I was peeing uncontrollably. Eek! My water had broken! In my car! Not exactly the way I had it envisioned (especially since I didn’t think my water would break until well into my birthing time), but I did my best to keep a cool head about me. I pulled over at my first opportunity to get that thick blanket and plastic bag out and to call my hubby, Todd. He somehow had a very calm demeanor (at least over the phone – he told me after the delivery that he was wearing a hole in the carpet waiting for me to get home) and told me to just stay calm and come home safely. I also called our doula, Sarah, to let her know that things were starting. I hadn’t felt any pressure waves yet, so we were both pretty sure that this would take a while – she didn’t come over right away.

When I arrived home, I decided that I needed to clean up and eat some dinner, so that’s what I did. I did my best to waddle into the bathroom and take a shower, then I went into the kitchen to heat up some of the casserole I had JUST prepped that afternoon and planned to freeze for our postpartum time. (I’m telling you – I had some sort of sixth sense about Charlie’s arrival that day… even though I didn’t consciously know he was coming, something in me did). I sent Todd to the store to pick up some depends so that I wouldn’t have to waddle around with a towel between my legs and so that we’d be more comfortable on the car ride to the hospital (something to plan on packing in advance next time!!). While he was away, I called my good friend, Caroline, to say that my birthing time had started but that I hadn’t noticed any PW’s yet. As we were talking, I was eating dinner and suddenly felt one for sure. It made me stop what I was doing and take notice, but was extremely far from being painful. I remember asking her, “is this really what they feel like?” She said, “well, if you need to stop talking while it’s happening, then yes, that’s what it is.” (of course I needed to stop talking… I was already automatically going “inside” myself to be sure to relax.) While we were on the phone, I had two or three more at about 5 minutes apart. Once Todd got home, I hung up with Caroline and went straight to my bedroom to focus on keeping myself in my zone. Todd called Sarah to come over right away, and I listened to my birthing day cd.

Once Sarah arrived, she joined me in our bedroom, and I kept feeling PW’s close together. I know I told her that I’d never done this before, but it seemed like things were progressing very quickly! After timing a few herself, she agreed that things seemed really close together for such an early time in my birthing time. None of us thought this would progress like this – Todd and I were sure we’d be watching a movie and chilling out at home for a long time and maybe heading in to the hospital the next morning. But I remember asking Sarah if we should go in to the hospital now since they were so close, and she said that if, at any time, there’s anything that would make me feel more comfortable, then that’s what I should do! Without hesitation, I knew that being at the hospital would make me feel more comfortable. Even though I felt like we’d prepared very well for our birthing time and had planned to stay home until it was really necessary to go, it turned out that I really wanted to be surrounded by people who had been through it a zillion times and could help guide me along. Todd suddenly found himself running around the house trying to pack for the hospital, even though I tried to tell him to just chill out and that it didn’t matter if I had my favorite slippers or not… I really needed him by me! He figured it out soon enough and we got packed into the car and went to the hospital at about 11:30 pm on 5/20. Of course, the one thing he forgot was the food that I’d bought for myself during my birthing time! So my energy bars and gatorade sat at home while we went through the next bit of my birthing time. Oh well! Lesson learned: be sure to pack well in advance next time!!

Once we arrived at the hospital, I blurrily remember a gentleman meeting us with a wheelchair and my signing a bunch of forms electronically at the front desk in the ER (since it was so late at night). Then they took us right up to my room in L&D where I got down to business. We had the CDs playing, and I’d rotate through different ones and take some time without them – I think we spent a lot of time on Deepening, and later on, we listened to the pushing your baby out track a whole lot. Anyway, right away, I pretty much stripped down – I was in a gown for a little while, but I know I absolutely didn’t care about modesty and just wanted to be comfortable. I asked to be checked and told that I was at 6 cm. Yay! After trying a few positions on the bed, Sarah asked if I’d like to sit on the toilet for a bit (since it can help to relieve the pressure), and I thought that could be nice. All of a sudden, I started feeling really nauseated. The nausea lasted for a few waves, and I kept saying that I thought I was going to puke but never did. Finally, after several minutes, there it came! Fortunately Sarah had had the foresight to grab a bedpan and bring herself a change of clothes… she and Todd definitely got hit. But I felt a million times better once it was out! And of course, that meant that I was in Transformation. So, we went ahead and had me checked and I was at 7.5 cm. Wow! That’s pretty good for having just checked in and for this being only a few hours after I felt my first wave. We were sure at this point that we’d have a baby by morning. Soon enough, I wanted to get off the toilet and tried relaxing on the bed for a while. At some point, Sarah asked if I’d like to get in the shower with the birthing ball, and I was all for it. I actually spent a lot of my birthing time in there – the hot water felt SO good on my back, and I wasn’t eligible for the tub at the hospital (long story – it’s just the way they have the usage rights structured). There was always someone at my side in the bathroom with a sip of cool juice at hand. And the nurse came in several times to check Charlie’s heartbeat during my waves. In addition to the shower, it felt really good to lean over the bed and sway my hips around or to go limp while holding around my hubby’s neck. I’m sure it wasn’t a cakewalk for him, but his strength became my strength.

So, it went on like that for a pretty long time. When we checked in, we were on the night shift with an OB (Dr Beyer). The next day, we had a midwife with us (Debra Wage) who was amazing. She was more than happy to let me go au natural as long as possible and only recommended a hep lock when it started looking like it was going to be a while. At some point, I remember asking to take the clock off the wall so I wouldn’t feel like I was in a race or that there was a time limit or anything like that. She also was extremely encouraging to me about the fact that I was so calm and able to move like a “normal” person. She said that she’d had three natural deliveries herself and that she “made a whole lot more noise than I did.” (I was making low, chesty sounds, but that was only because that’s what felt right – almost like long, low sighs. I really never felt like I was in pain or that I needed to grunt or scream). She also pointed out that I was being very nimble – she said that I was not moving like a woman in labor! Ha! That is to say, when I decided I wanted to be on the bed, I’d just climb on up without taking much time or needing much help… but I think that was partially because I wanted to be settled before another wave came on – I definitely noticed that they were a lot easier to handle if I was in a fully supported, comfortable position – just like the CDs kept saying during all my Hypnobabies training.

So, since things were slowing down by Thursday afternoon or evening (I honestly don’t remember – time was a total blur to me), she recommended that we think about adding some pitocin. I was physically exhausted at this point due to lack of sleep and nourishment, so my waves were petering out. I really didn’t want to use anything artificial to stimulate my waves, but she thought we were past the point of being able to use nipple stimulation or any other methods of natural augmentation. So, I reluctantly agreed to start on the smallest dose they could possibly give me and then let it grow from there as needed. They started me on 1 and eventually ramped it up to 4. That was the ONLY moment during my whole birthing time that I felt like I was in pain – when they loaded me up on 4. Until that point, I had only made low, chesty sounds during a wave, and at this point, I was struggling not to scream. Since I had been doing so well the whole time before that, they immediately ramped it back down and left it at 1. That was much better!

Eventually, there was another shift change and I was with Dr. Rush (whose first name was also Charlie), another OB. Finally, I had dilated all the way to 10 and was ready to push! Yay! Never in my entire life had it felt so good to push so hard. This is where I listened to the pushing your baby out track, and it was SO encouraging. I kept saying “yes” to the down and out moments, and I kept telling Charlie that I was ready to meet him and that I wanted him to come out. The whole room started getting into it and helping me remember “down and out.” Apparently, though, Charlie still wasn’t coming. (I honestly had no concept of time, so it didn’t really phase me that it was taking a while.) Dr. Rush had recommended that we use an intrauterine catheter to monitor the strength of my PW’s, and when we saw that there was plenty of force there, he did one exam to check his position during a wave. This was the only time an exam hurt at all (I didn’t even feel the other ones) – and I will say that it was extremely uncomfortable – I yelled at him to stop and get out of me and writhed a bit on the bed. But again, that was one of only two times that were unpleasant the whole time. Wow! At this point, we figured out the bigger reason why things weren’t progressing the way we would have liked for them to: Charlie was acynclytic (had his head cocked to the side like he was on the phone). After three hours of pushing like this and with Charlie’s heart rate starting to fall, Dr. Rush reluctantly brought up the idea of needing a c-section. As he said it, no one wanted to recommend medical intervention, especially not surgery, but it was starting to look dangerous for Charlie. He said that we could try pushing a little longer, but that if his heart rate didn’t improve, we’d end up in an emergency c-section situation where I’d be under general anesthesia and Todd wouldn’t be able to be there. He didn’t even need to say that part though – as soon as I knew that Charlie was in trouble, I was ready to let them get him out in whatever way necessary as long as he’d be safe.

As we went to the operating room, I remember wondering why they cared so much about covering me up (I was going through a hallway where there would be other people! hello!). My modesty really had gone out the window a long time ago, so it was all they could do to keep the sheet on me since I was just focused at that point at NOT pushing. All along the whole process, that was one of the hardest things I had to do – I really didn’t want to hurt Charlie, so I did my best to just breathe through the pushing waves instead of letting myself bear down and push. Once we got to the O.R., the anesthesiologist asked me if I was planning on continuing my hypnosis for the operation or if I’d prefer the spinal they had planned! Ha! I actually think he was partly serious. But I was all about the spinal at that point… no need to feel them cut me open – I hadn’t trained for feeling cutting as anything other than cutting (whereas pressure waves really did just feel like intense pressure to me rather than pain). I let them place the spinal, and this was the other hardest thing about the whole process – I had to stay perfectly still while I had waves telling me to push Charlie out. And I was in a seated position, which is how I found it was easiest to push back in L&D. Anyway, they placed the spinal after a bit of difficulty (I felt shooting pains down my right leg at first, as though someone had spilled acid and it was trickling down my leg… I literally thought they had sprayed me with something at first!). I asked them what it was, and they promptly took the needle out and tried again. Finally, after a few tries, they got it right and (thank God), I was fine and don’t have any resulting nerve damage. We proceeded with having me lie down on the operating bed, had my arms out parallel with my shoulders, and put the curtain up. Finally, Todd got to join me in the room (I guess they don’t want the husbands to see the needle going in the back or something), and I think he was even more nervous than I was at this point. I remember that my heart rate was pretty high, and we think that was a reaction to the anesthesia, but it could have also had to do with the fact that I was pretty freaked out – remember, I hadn’t really planned on this as something that was going to happen. I kept saying that it could happen, but I was in such a positive frame of mind about the delivery that I told myself that it wouldn’t happen.

Anyway, the surgery finally got underway, and it wasn’t long before I heard them say that he was out. One of the surgeons said: “Oh, aren’t you cute!!” and “you have a headache, don’t you?” This was right at the same time that they said that they needed to stimulate him to get him breathing, and within just a few seconds, I got to hear his sweet, beautiful and amazing cry. I felt like I was a million miles away from everything that was happening – almost like my head was on one side of the room and the rest of my body was on the other (probably a result of having the anesthesia and curtain up), and I didn’t even think to ask to see him. They told Todd that he could go and be with him, which he did (although he was a bit worried about having to walk by me to get to him – he really didn’t want to see my abdomen cut open). We have one adorable picture of Charlie still a little goopy, which I cling to since I didn’t get to see him like that with my own eyes. Pretty soon, they brought him to me all bundled up in his blanket and hat, and I had a very strong desire to strip him down so I could see him – but I just took off his hat and looked at his head, which had a large bump and bruise from where he got stuck! The poor thing. I remember telling Todd that I thought he looked just like his dad, and he agreed. After just a few brief moments with him, the nurse told us that they needed to take him to the nursery to do his assessments, so Todd and Charlie left while the surgeons finished up with me. I remember feeling a very strong pulling sensation as they were working on finishing me up – almost like they had their hands up under my ribs and were working with all their might! But it never hurt – just took a while and felt really funny. But eventually, they were done, and we got to go back to L&D, where my awesome nurse, Mary, kept an eye on my vitals and eventually left my side for the first time so she could work on some other cases she had (Sarah was still with me at this point). In fact – by the time I was pushing, the only time Mary left the room was to go to the bathroom, and even then, she had another nurse come in to keep an eye on things. Anyway, we waited for what felt like an hour until finally, Todd and Charlie came in with the pediatric nurse to get me acquainted with things (like the security device on his ankle). He was VERY ready to eat, so we promptly got nursing under way, and he was a total champ. Sarah made sure that we got a good start with that, helping me with positioning him and opening his mouth wide enough (especially since he had such a tiny chin), and then she finally got to go home and sleep. What a total champ and pro! I was and still am SO grateful to her for her help and loving guidance throughout the whole process.

At this point, Todd and I finally felt like we got to all be together like a family, and we started to do the typical things like counting fingers and toes – I was so grateful to get to finally see him in his birthday suit! Todd told me that there was a time when they were in the nursery that Charlie was just screaming and crying (which totally broke my heart – I was really looking forward to being able to start breast-feeding right away and comfort him and be with him for all of his assessments), but Todd offered him a finger and Charlie grabbed it right away and calmed right down. How amazing! So Todd was able to have that time to start his relationship with Charlie – a totally unexpected and beautiful side-effect of the way things worked out. Anyway, we were both totally thrilled to have Charlie with us and for us to all be together as a family, and they finally released me to the post-partum ward. Once there, Todd and I realized that we were absolutely exhausted (remember, I hadn’t slept much if at all this whole time on top of not eating and going through childbirth – plus, he had been my constant supporter the whole time). So we actually asked the nursery to take him for just a couple hours so we could sleep. Of course, though, this was our first time, so we didn’t realize that the time we were going to have him gone was going to coincide with the time everyone was going to be coming into our room to introduce themselves, see how I was doing, etc. So, even though Charlie was out of the room, we didn’t get more than about 15 minutes of actual rest… and I honestly didn’t sleep that well anyway. Finally, I told Todd that I needed him to go down to the nursery and bring Charlie back to me so I could put my mind at ease and get to know him better.

So, all in all, we had an absolutely beautiful birth with (almost) no pain at all – just intense pressure. And even though it resulted in a cesarean, I wouldn’t change a single thing about the entire process, and I’m forever grateful to the entire staff at Vanderbilt for their work and to Sarah McKay and 9 Months and Beyond for her awesome support. Tings I’d recommend to other moms to be and to myself for future births:

1. HIRE A DOULA. I cannot emphasize that enough. That was by far one of the best decisions we made for the whole process; what an awesome feeling of support, encouragement, and empowerment we got from Sarah!

2. Absolutely use the Hypnobabies method for a comfortable, natural child birth, and be sure to bring goodies for the nurses (although, don’t count on being able to bake something while you’re in your birthing time – pack a goodie bag with cookies and crackers and whatnot a few weeks in advance). If nothing else, surround yourself with a culture of information – it’s very empowering.

3. Pack for the hospital WAY before you think you need to. As in – be done with it by 35 weeks. Period.

4. Remember that there is nothing about birth that you can control other than your mindset, so keep it calm and open.

5. Be open to the fact that the delivery may end up being a cesarean so you’re not so shocked if it goes that way. I had to pretty much mourn the loss of my vaginal delivery – even though I didn’t “fail” at all, it felt like I had.

6. If you do end up with a cesarean, be sure to ask to see the baby right away – goop and everything. I definitely regret not seeing him while he was still purple or at least goopy. I also should have asked to see the placenta. This probably would have caused me to “grieve” less about not having a vaginal delivery.

7. If you’re really tired after your delivery, remember that the baby may be really tired too and might just sleep while you sleep – don’t just send him off to the nursery willy-nilly. You won’t be able to rest without him by you anyway. This is the biggest thing that I regret doing and I still frequently ask Todd if we did the right thing. Of course, we’re very bonded to Charlie now, but I think I would have had a quicker time bonding to him and would have probably felt a little less guilty in my post-partum time if I’d kept him in the room with me for those couple hours. Instead, I fought feelings of inadequacy and guilt, thinking that I was doing something wrong since I didn’t have a huge, gushy feeling or maternal drive right away… I think I almost saw Charlie as another baby I was baby-sitting and that his “real” parents would come back for him at any time… Now, of course, I absolutely feel like his mom, but again – maybe it would have happened sooner, or at least I wouldn’t have continually asked if I did the right thing in sending him to the nursery.

8. Also for post-partum time, be sure to pick a hospital or delivery place with plenty of great lactation support, or hire a post-partum doula, or be sure to surround yourself with lots of lactation help and other support. Even though it came pretty naturally to us, Charlie and I still had lots of help in establishing a solid breast-feeding relationship, and now I know pretty much automatically when he wants to eat, not to mention how to get his latch established (which we fixed so early on that it’s second nature to us now) and what to watch out for down the road. I’d highly recommend joining a breast-feeding support group or attending la leche league meetings. We were able to go to weekly meetings that our doula group held – they were called “weigh to go,” and our lactation consultant (who also happened to be our hypnobabies educator) could check in on how we were doing from a feeding perspective, we’d get to know other moms, and he’d get weighed to see how he was gaining. There was one week where he gained 10 ounces from the previous weigh-in! If nothing else, it was just very encouraging and helpful to me as a new mom to surround myself with other new moms and support people. If you live in the Nashville area, definitely check out 9 Months and Beyond – their services are absolutely invaluable. I don’t know how I would have had such a successful and amazing experience without their help.

9. Be sure to plan on doing absolutely nothing for a couple weeks after delivery. As my midwife put it, I was allowed to focus on feeding Charlie and getting better myself – nothing else. No shopping, no housework, no cooking, nothing. Get in your nest and stay there – don’t worry, you’ll want to. I wasn’t as good about this as I could have been (I was taken out shopping, we had a family wedding out of town that we had to go to, etc), and I felt like it took me a few extra weeks to get used to the idea of being a mom.